1. Field of the Invention
The subject invention is directed to an apparatus and method for closing incisions in blood vessels, and more particularly, to an apparatus and method for percutaneously applying a suture to the wall of a blood vessel to close a surgical incision formed therein.
2. Background of the Related Art
Surgical procedures requiring the introduction of a catheter into a blood vessel, such as the femoral or iliac artery, are well known in the art. Such procedures involve piercing the wall of the blood vessel, inserting an introducer sheath into the opening in the blood vessel, and maneuvering the catheter through the sheath to a target site within the blood vessel. At the conclusion of the procedure, it is necessary to seal the puncture wound in the wall of the blood vessel. It is common to accomplish this by applying direct pressure to the puncture site until homeostasis is achieved. This technique is time consuming, uncomfortable and can cause thrombosis, thereby presenting a danger to the patient.
Consequently, surgical instruments have been developed for suturing a puncture wound in a blood vessel, examples of which are disclosed in U.S. Pat. No. 5,746,755 to Wood et al., U.S. Pat. No. 5,836,955 to Beulna et al., U.S. Pat. No. 5,921,994 to Andreas et al., and U.S. Pat. No. 5,980,539 to Kontos. While these instruments provide improvements over common compression techniques, they remain difficult to use and unable to accomplish the desired task within a relatively short amount of time.
Therefore, it would be beneficial to provide a percutaneously apparatus and method for suturing a puncture wound in the wall of a blood vessel in a relatively short amount of time and with relative ease.
The subject invention is directed to a new and useful apparatus for percutaneously applying sutures, and more particularly, to an apparatus for closing an incision in the wall of a blood vessel in a relatively short amount of time and with relative ease as compared to prior art devices of its type.
The subject apparatus includes an elongated tubular body defining opposed proximal and distal end portions and having a longitudinal axis extending therethrough. The body includes an inner tubular member, an outer tubular member and a central tubular member disposed between the inner and outer tubular members. The inner tubular member and the central tubular member are mounted for movement relative to the outer tubular member about the longitudinal axis of the body.
The inner tubular member has an arcuate channel formed at the distal end thereof for carrying a pair of arcuate suture needles in back-to-back orientation within a plane extending generally perpendicular to the longitudinal axis of the body. The central tubular member has a distal driving stem extending into the arcuate channel of the inner tubular member and positioned between the pair of suture needles for sequentially driving the suture needles from the arcuate channel of the inner tubular member upon rotation of the central tubular member relative to the inner tubular member. The outer tubular member has an arcuate channel formed at the distal end thereof for receiving the pair of arcuate suture needles after the suture needles have been sequentially driven from the arcuate channel of the inner tubular member by the driving stem of the central tubular member.
An actuator is operatively associated with the proximal end portion of the tubular body for effectuating the relative movement of the inner tubular member and the central tubular member relative to the outer tubular member so as to cause sequential passing of the suture needles from the arcuate channel of the inner tubular member to the arcuate channel of the outer tubular member. Preferably, means are formed within the needle receiving channel of the outer tubular member for securely retaining the suture needles therein, and tissue gripping features are formed on exterior distal surfaces of the outer tubular member.
In accordance with a preferred embodiment of the subject invention, the inner tubular member, the central tubular member and the outer tubular member include cooperating overlying cam slots, and a cam pin extends through the overlying cooperating cam slots to cause the inner tubular member and the central tubular member to rotate relative to the outer tubular member. In addition, a proximal retaining pin is operatively associated with a proximal portion of the elongated tubular body for maintaining the relative axial positions of the outer tubular member, the central tubular inner tubular member and the inner tubular member. The cam pin is operatively connected to the actuator, the actuator is mounted for movement relative to a handle member, and the retaining pin is operatively connected to the handle member.
The subject invention is also directed to a method of suturing the wall of a blood vessel which includes the steps of positioning an elongated tubular body having a longitudinal axis extending therethrough adjacent an incision in the wall of a blood vessel, with the body including a first tubular member and a second tubular member, the first tubular member mounted for movement relative to the second tubular member about the longitudinal axis of the tubular body, and carrying first and second suture needles connected to one another by an elongated suture. The method further includes the sequential steps of passing the first suture needle from the first tubular member, through the wall of the blood vessel, to the second tubular member, and then subsequently passing the second suture needle from the first tubular member, through the wall of the blood vessel, to the second tubular member. The method further includes the steps of withdrawing the elongated tubular body from the wall of the blood vessel, and then tying a knot in the suture to close the incision in the wall of the blood vessel.
These and other aspects of the suturing apparatus and method of the subject invention and the method of using the same will become more readily apparent to those having ordinary skill in the art from the following detailed description of the invention taken in conjunction with the drawings described hereinbelow.